Pharm

• avanafil
• sildenafil
• tadalafil
• vardenafil

• Select Prototype Medications: sildenafil (Viagra)
• ●● Other Medications:
• tadalafil (Cialis),
• vardenafil (Levitra)

• Erectile dysfunction
• nitric oxide released during sexual stimulation, resulting in enhanced blood flow to the corpus cavernosum and penile erection.

• MI, sudden death
• (Monitor risk factors and history with regard to cardiovascular health)
• Priapism
• (Instruct clients to notify the provider if erection lasts more than 4 hr.)

• Contraindicated in clients taking any medications in the nitrate family, such as nitroglycerin.
• ●● Use cautiously in clients who have cardiovascular disease, including QT prolongation.
• ●● Advise clients that grapefruit juice may increase plasma concentrations and possible adverse effects of medication.

• Organic nitrates, such as nitroglycerin (Nitrostat)and isosorbide dinitrate (Isordil), can lead to fatal hypotension.
• (Discourage concurrent use of organic nitrates oralpha blockers.)
• Ketoconazole, erythromycin, cimetidine, ritonavir,and grapefruit juice inhibit metabolism of sildenafil,thereby increasing plasma levels of medication.
• (Use these medications cautiously in clients takingPDE5 inhibitors.)

• betamethasone
• dexamethasone
• diflorasone
• fluticasone
• mometasone

Glucocorticoid (Corticosteroids)

• Part of inhalation
• prevents inflammation, suppress airway mucus production, promote response to Beta 2 receptor
• Does not provide immediate effect, but rather promotes decrease frequency and severity of exacerbation and acute attack

Glucocorticoid use in combination with other antiemetic to treat chemotherapy-induced nausea and vomiting (CINV)

• Adrenal insufficiency(hypotension, dehydration, weakness, lethargy, vomiting, diarrhea associated with prolonged use)
• (Advise clients to observe for indications and to notify the provider if they occur.)
• Osteoporosis
• (Advise clients to take calcium supplements, vitamin D, and/or bisphosphonate (alendronate [Fosamax]).